Individual
SOPHIE LAFAYETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
351 GREENLEAF ST STE A, PARK CITY, IL 60085-5701
(847) 244-4110
Mailing address
5928 PALMER CT, FORT COLLINS, CO 80528-8865
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/15/2024
Last updated
08/28/2024
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